Castle Biosciences' COO Kristen Oelschlager sold 18,007 shares for $390,571 on August 29, 2025. The company recently published two studies validating its DecisionDx-SCC test and updated its bylaws. However, it faces potential risks due to possible FDA disruptions and reimbursement challenges. Despite this, Castle Biosciences reported strong Q2 2025 results with a 33% revenue increase and raised its revenue guidance for 2025. Spark's AI Analyst gives CSTL a Neutral rating.
Castle Biosciences, Inc. (Nasdaq: CSTL), a leading diagnostics company, has published two significant studies validating its DecisionDx-SCC test for high-risk cutaneous squamous cell carcinoma (SCC). The studies demonstrate the test's ability to predict local recurrence, metastasis risk, and response to adjuvant radiation therapy (ART) in patients classified as high-risk by the National Comprehensive Cancer Network (NCCN) guidelines who have undergone Mohs surgery [1].
The DecisionDx-SCC test, a 40-gene expression profile test, uses a patient’s tumor biology to predict individual risk of metastasis and response to ART. The first study showed that the test significantly outperformed traditional staging systems (AJCC and BWH) in stratifying both local recurrence and metastatic risk in NCCN high-risk SCC patients. The three-year local recurrence-free survival rates were 95.3% (Class 1), 85.5% (Class 2A), and 71.4% (Class 2B) [1].
The second study confirmed the clinical utility of the test by aligning its risk classifications with physician decision thresholds for ART and surveillance imaging. Most surveyed clinicians recommended ART for patients with ≥ 20% risk and surveillance imaging for those with ≥ 10% risk, matching the risk levels identified by the DecisionDx-SCC test classes [1].
Despite these positive developments, the company faces potential risks. Castle Biosciences' COO, Kristen Oelschlager, sold 18,007 shares for $390,571 on August 29, 2025 [2]. The company also updated its bylaws and may face challenges with FDA disruptions and reimbursement. However, Castle Biosciences reported strong Q2 2025 results with a 33% revenue increase and raised its revenue guidance for 2025 [2]. Spark's AI Analyst gives CSTL a Neutral rating.
References:
[1] https://www.stocktitan.net/news/CSTL/new-evidence-published-supporting-use-of-decision-dx-scc-test-in-05nesouqwdeu.html
[2] https://www.stocktitan.net/news/CSTL/coo-sells-shares-amid-positive-q2-results-and-updated-bylaws
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